| NPI | 1619257045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID JOHN EICHENHOFER Psychologist 262-241-1515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 2989-123) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WI 1457-57) |
| 106H00000X Marriage & Family Therapist (Licence: WI 308-124) | |
| Enumeration Date | 2011-08-17 |
| Last Update Date | 2013-06-07 |